Successful treatment of bilateral paecilomyces pyelonephritis in a German shepherd dog

Abstract

A six-year-old female entire German shepherd dog was investigated for polyuria, polydipsia and lethargy. Investigations revealed a mild azotaemia and abdominal ultrasound revealed marked bilateral dilation of the renal pelves with echogenic material and proximal left hydroureter. Urine cytological examination and aspirates from the right renal pelvis revealed mats of fungal hyphae consistent with fungal bezoar formation. Fungal cultures revealed a profuse growth of Paecilomyces variotii. Initial treatment with oral itraconazole was unsuccessful, leading to bilateral nephrotomies to remove the fungal material. Postoperatively the Paecilomyces infection persisted despite continued itraconazole therapy. Treatment was commenced with amphotericin B, leading to resolution of the dog's clinical signs. To the authors' knowledge this is the first report of canine Paecilomyces pyelonephritis, without disseminated systemic disease, which documents its successful treatment.

Rasamsonia argillacea mycosis in a dog: first case in Europe

“…After the second positive urine sample, voriconazole was proposed to the owner; however this was declined because of high costs. Potentially, local antifungal treatment of the urinary tract could have been considered in this case (Starkey and MC Loughlin 2008, Tappin and others 2012); however, this animal had a disseminated infection involving multiple sites, including lungs, skin, disc spaces, urine and blood. Despite these other treatment options, both, human beings and dogs with disseminated fungal diseasees continue to have poor prognoses (Kelly and others 1995, Watt and others 1995).…”

Rasamsonia argillacea mycosis in a dog: first case in Europe

“…Because of the water solubility of voriconazole, it is possible that voriconazole might have eradicated the urinary tract infection better than itraconazole, which is lipophilic, leading to lower concentrations in body fluids (Willems and others 2001, Lipp 2008, Heinz and others 2013). After the second positive urine sample, voriconazole was proposed to the owner; however this was declined because of high costs.…”

“…Despite a dramatic initial clinical and radiographic improvement to itraconazole in this dog, complete elimination of the fungus was unsuccessful with persistence in the urine, and the dog was euthanased seven months after presentation. Because of the water solubility of voriconazole, it is possible that voriconazole might have eradicated the urinary tract infection better than itraconazole, which is lipophilic, leading to lower concentrations in body fluids (Willems and others 2001, Lipp 2008, Heinz and others 2013). After the second positive urine sample, voriconazole was proposed to the owner; however this was declined because of high costs.…”

“…No signs of immunosuppression were found in this case. However, German shepherd dogs are recognised to be prone to fungal disease (Kelly and others 1995, Watt and others 1995, Smith and others 2000, Booth and others 2001, Bruchim and others 2006, Zanatta and others 2006, Schultz and others 2008, Krockenberger and others 2011, Saey and others 2011, Zhang and others 2013). Because of the breed susceptibility of German shepherd dogs to fungal diseases, and the interest for human susceptibility of these unusual diseases, the authors have started collaboration into the search of a genetic underlying immunosuppressive factor in German shepherd dogs.…”

Disseminated Rasamsonia argillacea species complex infections in 8 dogs

“…Aspergillus terreus , Aspergillus deflectus , and Aspergillus niger each have been reported to result in disseminated infections and German Shepherd dogs appear to be overrepresented, although the disease also has been reported in other dog breeds 2 . A variety of other molds, including Penicillium spp., Talaromyces spp., and Paecilomyces spp., also can cause disseminated infections in dogs 3‐6 …”